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Anesthesia Basic Exam > Random facts > Flashcards

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1
Q

what law

Q = ΔP(π * radius4) / (8 * viscosity * length) Where: Q = flow, Δ = change in, P = pressure, π = 3.14

A

Pousilles law

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2
Q

what law

law indicates that at a constant temperature, the concentration of a gas dissolved in a solution is directly proportional to the partial pressure of that gas: C = kP (where k is a solubility constant)

A

henry’s law

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3
Q

what law

A fixed mass of gas at constant temperature will have a constant pressure-volume product: P1V1 = P2V2 or P ∝ 1/V.

A

boyles law

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4
Q

what law

the pressure of a given mass of gas is directly proportional to its temperature when at a constant volume: P1/T1 = P2/T2 or P ∝ T.

A

guy lussaics law

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5
Q

what law

the volume of a given mass of gas is directly proportional to its temperature when at a constant pressure: V1/T1 = V2/T2 or V ∝ T.

A

charles law

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6
Q

what law

indicates that the total pressure exerted by a mixture of gases is the sum of the individual gases’ partial pressures: PTotal = P1 + P2 + P3 + … + Pn. Dalton’s law explains why at higher altitudes, a greater volume percentage of volatile anesthetic must be delivered to maintain the same anesthetic level as at a lower altitude. At higher altitudes, the total pressure (i.e., atmospheric pressure) decreases, which means the partial pressures of all the individual gases decrease by the same proportion

A

daltons law

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7
Q

Reynolds number is used to predict what and what is the equation

A

turbulent flow

Velocity x density x diameter / viscosity

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8
Q

chi square testing

A

compare 2 populations to 1 discrete (not continuous) variable
ordinal or nominal

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9
Q

unpaired T test

A

Comparison of 2 populations with respect to a single variable with CONTINUOS data

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10
Q

paired T test

A

1 group only
Used in experiments before and after a single treatment in the same population

-UOP before and after a group of 10 pts who received Lasix

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11
Q

ANOVA

A

same as paired T test but more than 1 variable

-before and after tx in same population

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12
Q

mann whitney

A

study used to rank 1st, 2nd, 3rd

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13
Q

o Compare multiple variables each with discrete values

A

logistic regression

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14
Q

SID equation and what does NS do

A

( [Na+] + [K+] + [Ca2+] + [Mg2+] ) - ( [Cl-] + [A-] ) ≈ 40-44 mEq/L
NS decreases SID

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15
Q

hypoalbuminemia can occur from severe what. dose adjustment for each

  • LAs
  • BBs
  • Benzos
  • opioids
A

severe burns

  • LA and BB need increased dose
  • benzos have higher free fraction so decrease dose
  • same with opioids
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16
Q

burns and succinylcholine and NDNBM

A

1 day to 1 year sensitive to sux

if >30% burns of body then at 1 week NDNMB become more resistant

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17
Q

thyroid hormones and potassium

A

increase cellular uptake

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18
Q

size of pads for defib

A

8-12 cm, decreases resistance

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19
Q

OSA criteria and mild vs mod vs severe

A

STOP BANG

Snoring, tiredness during day, observed apnea, pressures (HTN), BMI >35, age >50, neck size, gender (male). if yes to 3 then at least intermediate risk

complete apnea for 10 seconds 5 times an hour

mild: 5-15
moderate: 15-30
severe >30

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20
Q

how does 2-chlorprocane cause spasms

A

EDTA chelates calcium, transient

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21
Q

what is in cryoprecipitate

A

factor VIII, fibronectin, fibrinogen, XIII, VwF

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22
Q

echothiophate and sux

A

inhibits pseudocholinesterase
can prolong sux

Echos succcckkkk

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23
Q

cyclopentolate use and tox

A

anticholinergic drug, used for eye procedures to cause mydriasis

anticholinergic tox possible

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24
Q

diastolic HF and SVR

A

need increased afterload to perfuse coronaries or else empties too much

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25
do volatile anesthetics preserve hepatic blood flow
yes
26
hemophilia C is reduction of what factor
XI
27
hemophilia A inheritance
X linked recessive
28
esophageal spchinter tone and sux
UES decreased | LES increased
29
H2 blockers onset time for oral onset time for IV
oral: all 60 minutes IV: ranitidine 60 minutes; cimitidine and famotidine 30 minutes
30
NK-1 receptor antagonist and when to give during surgery
aprepitant, beginning
31
dopamine receptor antagonist and when to give and dose
droperidol: end of surgrery: 0.625 to 1.25 mg reglan: 25 mg; don't give if gave zofran
32
severe AS: Valve area less than ___ cm^2 and transvalvular pressure gradient > ___ goals with HR and rhythm, and SVR
0.8 cm^2 transvalvular pressure gradient >50 mmhg ``` slower HR (increase filling) NSR (atrial kick) maintain SVR (distal to stenotic lesion to perfuse coronaries) ```
33
is cardiac ressucitation usually successful in AS pts
no
34
what VA has an intermediate HFA that is reactive and dangerous to liver
desflurane
35
what enzymes does NO inhibit
methionine synthetasea | thymidilate synthetase
36
large R wave in V1 can be from what
RVH, WPW, posterior wall MI, RAE, MD
37
flow rates nasal cannula
25-40% with flow rates up to 6L
38
flow rates simple facemask
35-50% with flow rates >5L/min KD (35-50) 5 L
39
flow rates partial rebreather
40-70% fio2 with flow rates >6L/min
40
flow rates nonrebreather
60-80% fio2 with flow rates 10L/min
41
suggamadex allergy if pt is allergic to what
cyclodextrans
42
level of spinal blockade: not dependent on which one dose (mg), volume, baricity, pt position
volume
43
milrinone dose in renal failure
decrease it
44
cyp 3A4 system ramped up metabolizes what what about 2C9 what about 2C19
MALO midaz, alfent, lidocaine, OCps 2C9 = NSAIDs 2C19: clopidogrel
45
ABO incompatibility and fibrinogen
decreases
46
what does cytochrome P450 do
oxidizes compounds
47
MELD
I crush several beers daily INR, creatinine, sodium, bilirubin, dialysis
48
childs pugh
Pour Another Beer At Eleven PT, ascites, bilirubin, albumin, encephalopathy
49
FRC = TLC -
inspiratory capacity
50
increase in closing capacity
ACLS-S(O?) aging, chronic bronchitis, LV failure, surgery, smoking, (obesity?)
51
which nerve in LE not affected in the lithotomy position
posterior cutaneous nerve | S1-S3
52
hypoxic pulmonary vasoconstriction and VAs
usually conserved at 1.0 MAC but above blunts it
53
how to treat nitroprusside tox
amyl nitrate
54
chemo drug toxicites cyclophos 5-FU, 6 MP, methotrexate traztusimab bleomycin, busulfn
cyclophosphamide: hemorrhagic cystitis 5-Fu, 6-MP, methotrexate: myelosuppresion traz: cardiac tox bleo and busulfin: pulmonary fibrosis
55
common pseudocholinesterase deficiency variants
A and K
56
hyperthryoidism; which occur pleural effusion, anemia, thrombocytopenia
anemia and thrombocytopenia possible, no pleural effusion
57
FRC in adult
30 ml/kg
58
what is a clark electrode and needs what to work
measures partial pressure of O2 needs electricity to work
59
absorbants: ones with stronger bases more likely to do what? examples barylime and sodalime newer absorbants have what which are better for this
create CO KOH > NaOH > Ba(OH)2 > Ca(OH)2 baralyme > sodalime new ones: CaOH
60
Sexy DARling
at 660 nm, Deoxyhemoglobin Absorbs Red light so at 940 oxyhemoglobin absorbs infrared light
61
vapor pressure of VAs
VP going to make the pot lid DHIS desflurane > halothane > isoflurane > sevoflurane 681 > 243 > 240 > 160
62
N20 tank L and PSI
745 PSI 1600 L will read 745 PSI until about 16% full or 253L remains
63
hypoxic mixture delivery first sign
oxygen analyzer alarm
64
bioavailability of midazolam
MuNRO muscle, nasal, rectal, oral
65
pre-oxygenation
FRC in adult is 30ml/kg oxygen consumption is 3-4/ml/kg/min time till hypoxemia FRC/O2 consumption x O2% in FRC
66
PPI must be given how soon before surgery and last how long
1 hr, 24 hours
67
how soon before surgery can sodium bicarb be given
15-30 minutes before
68
MAC requirments change __% per decade rises at __ month, peaks at __, normal at __
6% rises at 1 month, peaks at 6 months, normal at 12 months
69
what surgeries should ASA be held for
``` intracranial NSGY middle ear surgery posterior eye surgery intramedullary spine surgery possibly for prostate surgery ```
70
pressure vs FiO2
directly proportional so double one = double other
71
pregnancy, lithium and verapimil do what to MAC
decrease it
72
sweat glands appocrine eccrine
appocrine: lips, tips (of penis) and clits eccrine all else sympathetic: acetylcholine to nACHR then acetylcholine to muscarinic
73
hemophilia A and bleeding tx
- Recombinant factor VIII - Sometimes develop antibodies - Then give: procine factor 8, recombinant factor VII or II
74
papillary muscle mitral valve regurge
``` o Posteromedial papillary muscle rupture  Receives single blood supply from RCA  More susceptible to rupture o Anterolateral  Blood supply from • LAD and LCA ```
75
absolute contraindications of ECTs
o Pheochromocytoma, intracranial mass, recent MI <4-6 weeks, CVA last 3 months or intracranial surgery last 3 months, unstable C spine
76
axillary nerve block misses what nerve and where do you block it
musculocutaneous nerve, in coracobrachialis m
77
surfactant and laplace's law
2T/R | T = surface tension
78
which clotting factors decrease in pregnancy
XI, XIII, S and C | PT and PTT shorten
79
ACT time variability causes
hemodilution, hypothermia, platelet counts below 30-50k, administration of meds
80
thermodilution underestimation
temp injected is lower than programmed Large fluid bolus administered Measured probe is warmer than injectable stuff
81
anticoagulation and when to stop GIIBIIIA inhibitors clopidogrel ticlodipine dypyridamole
TEA for the BAdasses tirofiban: 24 hrs eptifibatide: 24 hrs abciximab: 72 hrs (ABC = 3 letters so 3 days) clopidogrel: 5 days ticlodipine: 10-14 days dyp: 24 hrs
82
what do you want CPP for pt with TBI
50-70 mmhg
83
QT and hyperphosphatemia
prolonged
84
liver donation adult to child, what lobe what about adult to adult
left need right for adult to adult
85
CYP and drug it metabolizes 3A4 2C9 2D6 2C19
3A4: LAs, decadron, fentanyl, methadone, anesthetics 2C9: WIP( warfarin, ibuprofen, phenytoin) 2D6: BB, diltiazem, tramadol, antiarythmics, codeine 2C19: PPIs, SSRIs
86
treatment of hypermagnesemia
calcium
87
toxic levels of magnesium bradycardia and hypotension ECG changes heart block cardiac arrest
bradycardia and hypotension: 5-6 ECG changes: 6-12 heart block: 18 cardiac arrest: 20
88
how is nicardipine metabolized
by the liver | ni CARD I B Pine drinks her liver away
89
CYP inhibitors
STICKFACES.COM Group sodium valproate, ticlodipine, INH, cimitedine, ketocanazole, fluconazole, alcohol (acute), amiodarone, erythromycin, sulfonamides, cranberry juice, omeprazole, metronidazole, grapefruit juice
90
CYP inducers
BS CRAP GPS barbs/benzos, st johns wart, carbamazapine, rifampin, alcohol (chronic), phenytoin, griseofulvin, phenobarbital, sulfonalureas (DM drugs)
91
botulism treatment
> 1 equine | < 1 human IG
92
tidal volume calculation men women
men: 50 + 2.3 (height in inches - 60) women: 45.5 + 2.3 (height in inches - 60)
93
distal compared to proximal arterial waveform. dichrotic notch
delayed and blunted
94
CVP waveform changes | Atrial fibrillation
AFib: loss of a wave
95
CVP | AV dissocaition
cannon A wave
96
CVP | tricuspid regurgitation
tall c and v, loss of x descent
97
CVP | tricuspide stenosis
tall a and v wave minimal y descent
98
CVP | RV ischemia
tall a and v waves, steep x and y descent, M or W configuration
99
CVP | pericardial constriction
tall a and v waves, steep x and y descent, M or W config
100
CVP | cardiac tamponade
dominant x descent, minimal y descent
101
CVP ``` a wave c wave x descent v weave y descent ```
a – atrial contraction c – tricuspid valve bulging into right atrium during right ventricle isovolemic contraction x – tricuspid valve descends into right ventricle with ventricular ejection v – venous return to the right atrium y – atrial emptying into right ventricle through open tricuspid valve
102
parkland formula
3-4ml x TBSA (%) x body weight (kg); | 50% given in first eight hours; 50% given in next 16 hours

Anesthesia Basic Exam (2 decks)

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